For many years, institutional ministries were the proudest boast of American Catholicism. Stretching from coast to coast and serving millions of people, the vast network of hospitals, charities, and colleges and universities under Church auspices was among the wonders of the Catholic world. But is it still?

Battered by market forces, winds of social change, secularist antipathy and post-Second Vatican Council conflicts in the Church, the institutional ministries inherited from earlier Catholic generations exhibit mission fatigue, must often struggle to stay in business, and find it hard to locate, much less hire and retain, enough faithful Catholics to sustain a vibrant Catholic identity.

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In need of renewal

To some observers, this points to a difficult but inescapable conclusion: It’s time for a new, evangelical set of institutional ministries to meet the needs of Church and society in the 21st century and give perspicuous witness to the Gospel. This shift would provide support and badly needed direction to a newly emerging American Catholic subculture that currently exhibits disturbing limitations and blind spots.

In saying this, we take our lead from words of Blessed Pope John Paul II, spoken Sept. 16, 1987, to the American bishops convened in Los Angeles: “The renewal of Catholic life which the [Second Vatican] Council called for is to be measured not primarily in terms of external structures, but in deeper and more effective implementation of the core vision of her true nature and mission.”

There’s great wisdom, too, in an insight from the eminent theologian Cardinal Avery Dulles, S.J. Speaking of the tension between the Church’s evangelical raison d’etre and the temporal structures it employs, he said: “No one doubts that health, education, and welfare are good and necessary things. But that is not by itself a reason why the Church ought to do them. Otherwise the Church would have to grow vegetables, maintain a police force, and manufacture clothes. The Church is not called to do everything good but only to do those good things that fall within its divinely given mission.”

Changing landscape

Originally, the institutional ministries of the Church in America (which in fact might better be called “apostolates”) were designed to do that. But times change, and the contingent circumstances that called these great works into being for the most part no longer exist.

The Loss of 'Primal Identity'

The subculture of the hyphenated Catholics has been called a ghetto, and in many respects a ghetto it was. But it also had significant strengths, as former Newsweek religion editor Kenneth Woodward recalls in his recollections of growing up Catholic in a Cleveland suburb. To be sure, he writes, other religious bodies also had subcultures, but the unique comprehensiveness of the American Catholic version instilled “a primal identity that absorbed and conditioned all the others” (Kenneth L. Woodward, “Memories of a Catholic Boyhood,” First Things, April 2011).

Take Catholic hospitals. On paper, they’re doing very well — 629 facilities caring for 88.5 million patients in 2012. But reality is more complex than the numbers suggest.

The first hospitals in America bore little resemblance to present-day acute care facilities. They were nursing homes for the sick and dying, a cross between today’s hospices and long-term care facilities. Catholic hospitals first appeared in response to the hostility to the Catholic faith existing in some of these institutions — for example, public hospitals that made it difficult for priests to administer the last rites on their premises. Catholics often chose a Catholic hospital as much for spiritual consolation as physical care.

Not any more. By the early 1920s, somewhere between 15,000 and 20,000 religious sisters were working in Catholic hospitals in the United States and Canada. Now a patient in one of these institutions may never see a professed religious woman there. In 1930, there were dozens of Catholic hospitals in New York City alone. Now there is none. Catholic medical schools in the United States have nearly disappeared.

Several causes produced these results. The drop-off in the number of religious sisters is one. So are market pressures driving Catholic hospitals into consolidations, which often means partnering with secular health care providers. And so is lack of interest among Catholics in receiving specifically Catholic health care. When Catholics get sick, they go to the hospital where their doctor practices or their health insurance tells them to go.

Identity issues

Catholic colleges and universities present a similar picture. Catholic higher education is statistically thriving — 255 colleges and universities with 812,000 students, up a quarter of a million since 1987. But the Catholic identity of many of these schools is another matter.

Exceptions to the Trend

Though greatly reduced in numbers and enrollment since the last quarter century (9,107 schools with 2.8 million students in 1987, 7,090 schools enrolling 2.1 million now), most Catholic elementary and secondary schools retain strong ties to the Church and, when doing their job, play a key role in the religious formation of the rising generation of committed Catholics. That can hardly be said of many colleges and universities, social service programs, and hospitals that still carry the name Catholic.

In 1967, representatives of seven Catholic universities (Boston College, The Catholic University of America, Fordham University, Georgetown University, the University of Notre Dame, St. Louis University and Seton Hall University) adopted what became known as the Land O’Lakes Document. “True autonomy and academic freedom, in the face of authority of whatever kind” was declared to be the sine qua non of a modern Catholic university. Soon this declaration of independence from the Church’s magisterium was taken up by most other Catholic schools.

Since then, much of the story of Catholic higher education has been a tale of tension and conflict with Church leadership. Blessed Pope John Paul II’s 1990 apostolic constitution on higher education Ex Corde Ecclesiae sought to uphold the magisterium’s interests and rights in regard to schools. But that effort has been only partially successful.

Conditions for support

As with higher education, so with Catholic Charities. The total volume of services provided has never been higher. But what is being done would be largely unrecognizable by anyone who dozed off during the Depression and woke up now.

Today’s Catholic Charities is mainly a government contractor, with more than 60 percent of the budget coming from public sources. But the many institutions (orphanages, industrial schools, homes for troubled girls) created by the Church for child care at a time when public institutions and services had no interest in sustaining dependent children in the faith of their deceased or distressed Catholic parents have long since shrunk to vanishing point.

Since at least the 1960s, it has been impossible for almost any Catholic social services program — or any Catholic hospital or Catholic university — to survive without government grants or subsidized patronage in the form of student loans, Medicare or Medicaid. Often, too, Catholic institutions have used their dependence on government money as an excuse to jettison or compromise their missions.

In other cases, conditions attached to government support have driven Church programs out of existence. In Massachusetts, Illinois and Washington, D.C., for example, the government’s requirement that children be placed for foster care or adoption with qualifying same-sex couples has forced Catholic Charities to withdraw from foster care and adoption work.

To be sure, this isn’t the first time Catholic institutional ministries in America have come under government assault. Motivated by hostility to Catholics and immigrants, Oregon in the early 1920s moved to outlaw Catholic and other nonpublic schools. But a unanimous 1925 Supreme Court decision (Pierce v. Society of Sisters) upheld parental rights and thus, incidentally, the autonomy of religious institutions. “The child,” the court declared, “is not the mere creature of the state.”

Lately, though, government has returned to the attack — but with a difference. For the first time ever, the aim is to force church-related programs, as well as individuals motivated by religious conviction, to cooperate in something they regard as moral evil.

The most conspicuous example so far is the much-publicized Department of Health and Human Services mandate by which President Barack Obama’s administration seeks to compel institutions and programs under religious sponsorship, including colleges and universities, charities and hospitals, together with private businesses run by people with religiously based objections, to provide employee health coverage that includes contraceptives, abortion-inducing drugs and sterilization. Numerous court challenges to the administration policy are pending.

No matter how that struggle turns out, efforts at the federal, state and local levels to impose institutional martyrdom on religion in America in the name of various reproductive and gender-related “rights” are likely to continue well beyond the Obama years. Increasingly, laws and regulations will, in the words of Cardinal Francis George of Chicago, “make it impossible for Catholic institutions to follow their conscience.”

For its own sake and the sake of the common good, the Church plainly must resist this government aggression in legislatures and courts. But the Church may lose; and win or lose, this ugly new fact of American life, far from removing the need for new institutional ministries, makes it all the more urgent.

A new subculture

The crisis of institutional ministries is occurring in an ecclesial and social context largely shaped by the Church’s continuing effort to recover from the traumatic dismantling in the 1950s and 1960s of the Catholic subculture that had existed up to then. The aim now is to create a new Catholic subculture suited to the needs of today’s Church and society.

PAST: Two Franciscan Missionaries of Mary with children and “Davy Crockett” at Kennedy Memorial Hospital. OSV archive

EXAMPLE: Dr. John Bruchalski hugs a patient after her visit to the Tepeyac Family Center, a pro-life OB/GYN practice in Fairfax, Va. CNS photo

The limitations and faults of the old subculture — that world of ethnic Catholicism which grew up in America in the 19th and early 20th centuries and had its heyday in the 1920s, ’30s and ’40s — have often been decried. The subculture of the so-called hyphenated Catholics — Irish-American, Italian-American, Polish-American and the rest — has been called a ghetto, and in some ways it was. But it also had significant strengths that combined to forge a strong religious identity in several generations of Catholics.

By the late 1950s, however, Catholics were already assimilating into a secular culture described by historian Charles Morris as being “if not quite areligious, at least highly latitudinarian.”

The “uniquely Catholic cultural machinery” didn’t merely break down, Morris notes. On the contrary, it was destroyed — partly by the movement of Catholics from urban neighborhoods focused on parishes to geographically dispersed, ethnically and religiously anonymous suburbs, and partly by a project of deliberate cultural destruction masterminded by Catholic intellectuals with the tacit assent of Church leaders. Virtually overnight, scores of organizations, groups, movements and institutions that had made up the many-colored tapestry of the Catholic subculture simply disappeared.

Morris calls this “a fearsome exercise … nothing less than the dangerous and potentially catastrophic project of severing the connection between the Catholic religion and the separatist American Catholic culture that had always been the source of its dynamism, its appeal, and in its power.”

This contributed to the crisis of the Church in the past four decades, as Catholics busy assimilating into a secular culture ever more hostile to Catholic values experienced an erosion of religious identity.

Nevertheless, in recent years a new Catholic subculture has begun to emerge — or, rather, the “plausibility structure” of one has emerged. (Plausibility structure is a name coined by social scientists for the network of institutions and programs that express, reinforce and help to propagate the values of a culture.)

It can be seen in a handful of proudly orthodox Catholic colleges and universities, in media ventures like the Eternal Word Television Network and Catholic radio, in new organizations, websites and blogs, periodicals and publishing houses, and in groups and movements dedicated to the promoting of Catholic faith and spirituality. In other cases, older Catholic institutions and programs have acted to reaffirm their Catholic identity. Often all this has the active encouragement of a new generation of bishops and priests who share the same vision.

Up to a point, it’s all to the good. Unfortunately, though, alongside much that is wholesome and hopeful, here and there signs of a new ghetto mentality can be discerned in this emergent Catholic subculture — a self-regarding, inward-looking, defensive state of mind moving those who share it to shun contamination by the secular world.

The fundamental insight here is sound: the dominant secular culture of contemporary America really is a threat to religious faith and values. But this secular culture also is the world that Christians must labor to evangelize. And that won’t happen by simply raising the ramparts against secularism. Just here is where the new institutional ministries come in, as embodiments of the perspicuous witness to faith that Christians are called to give, even — or especially — in circumstances like these.

In his motu proprio De Caritate Ministranda(“On The Service of Charity”), issued last December, Pope Emeritus Benedict XVI insisted that Catholic social services (and, he might have added, Catholic health care and Catholic higher education) “must avoid … becoming just another form of organized social assistance.” On the contrary, he said, the essence of institutional ministry is and must remain “helping people to appreciate the importance of sharing, respect and love in the spirit of the Gospel of Christ.”

What needs doing will be difficult, certainly, but it’s not impossible. In general, it goes like this.

Emerging models

The prognosis for the apostolic character of today’s mega-ministries is grim. With few if any exceptions, half-billion-dollar hospitals, research universities and publicly subsidized Catholic social services cannot be sustained as genuinely Catholic enterprises. There should be no purges, no radical ruptures: The mega-ministries should be allowed to go their own way, with good wishes from the Church. And if some wish to adapt and continue as Catholic institutions — all the better.

EXAMPLE: Residents eat lunch at the Catholic Worker’s St. Joseph House in New York. CNS photo

Meanwhile, the emerging new institutional ministries will be of two kinds. Some will be modified versions or recognizable adaptations of institutions that now exist, such as Catholic Worker houses, St. Vincent de Paul societies and hospices. Catholics should also continue to cultivate the existing handful of orthodox Catholic colleges committed to bearing witness to the Gospel while providing academically excellent education. And Catholic elementary and secondary schools where the Faith is taught and lived should be promoted and given all possible support.

In higher education, the most promising new initiative may be the creation of Catholic residential colleges at public and non-Catholic private universities. These will be places where young women and men can enjoy a Catholic educational, social and religious milieu as part of their experience of higher education.

In health care, the future lies with expanded hospice programs and storefront or mobile treatment facilities staffed by health care professionals that offer services to underserved populations such as migrant workers. In social services, similarly, the future will see a variety of programs serving immigrants, prison inmates, parolees and other socially marginal groups.

The second sort of institutional ministry will consist of structured, creative new responses to the most pressing pastoral problems of the day, especially in the areas of procreation, the defense of human life, and the preservation and support of marriage and family. This points to a multitude of counseling and mental health services offering Christian alternatives to the options so often favored by government, professional associations, and the media — contraception, abortion, cohabitation, divorce and same-sex relations.

The institutional ministries of the future will be large in number but individually smaller and leaner than today’s mega-ministries. They will offer their services to the spiritually poor as well as those materially disadvantaged. They will be largely lay-initiated and lay-managed, and will rely more on volunteers than on paid staff. As an integral and preeminent part of a new Catholic subculture, they will be proudly and visibly evangelical, giving witness to the Gospel in word as well as deed.

Does this approach to the Church’s institutional ministries have a highly placed friend in Rome? It looks as if it may.

In a book written with a rabbi friend before his election, Pope Francis quoted something Blessed Pope John Paul II once said: “A faith that does not produce culture is not a true faith.” Today, Pope Francis added, there are “idolatrous cultures” like “consumerism, relativism and hedonism” that must be recognized and resisted. In a special way, then, the task of the Church’s new institutional ministries may be to offer a religious alternative to the idolatrous cultures of our times.

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